Individual provider Active NPI

John Jay Marcelo Mercado

  • Physical Therapy Assistant
  • Seattle, WA
National Provider Identifier
1760124689
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P160668651 Issued in WA
Practice address
8760 Greenwood Ave N Apt N502
Seattle, WA 98103-3678
Phone
(361) 537-9464
NPI assigned
Apr 11, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P160668651 WA Primary

Addresses

Primary practice location

8760 Greenwood Ave N Apt N502
Seattle, WA 98103-3678

Mailing address

8760 Greenwood Ave N Apt N502
Seattle, WA 98103-3678
Phone (361) 537-9464

Other identifiers 1

IdentifierTypeStateIssuer
709350OtherPROFESSIONAL ORGANIZATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P160668651WAMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1760124689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8760 GREENWOOD AVE N APT N502",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981033678",
            "telephone_number": "361-537-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8760 GREENWOOD AVE N APT N502",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981033678",
            "telephone_number": "361-537-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "JOHN JAY MARCELO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160668651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL ORGANIZATION",
            "identifier": "709350",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.